Nurses in the clinical area: Relevance of a PhD

This project aimed to explore the application and relevance of a PhD to nurses working in the clinical area. The complexity of nursing practice requires clinical nurses to be competent as investigators and professional leaders who could help structure nursing practice in more efficient ways. Research proposes that a PhD offers limited employment opportunities, is mainly research oriented and tends to direct a nurse away from the clinical field. A mixed method study design utilising surveys and interviews was chosen to collect data for this study. Participants were nurses with a doctoral degree working/having worked in a clinical area after obtaining their PhD Nurses were recruited through student databases from Australian universities that offer doctoral degrees in nursing and also by using a snowball sampling technique. The majority of the 19 nurses who participated in the study had: varied expectation of doing a PhD; maintained their clinical positions after obtaining their doctoral degree, considered that the degree helped them to obtain better jobs/promotions and acknowledged the value of the PhD in patient care, in improving research and informing health policy. This study has exposed the positive aspects of completing a PhD and identifies its constructive application in the clinical area. It is essential to provide support and opportunities for nurses working in the clinical area to pursue doctoral degrees in order to enable them to enhance knowledge and build confidence and leadership skills and contribute to the improvement of nursing practice and the continued development of the profession.     

Joint nursing appointments: a vehicle for influencing health care change

With the rapid pace of health care change nurses need to organize and respond quickly to the debate on future health care policy Nurses from practice and academia working together can capitalize on their unique knowledge and expertise to influence the development of consumer- and health-oriented policies In the past joint appointments have served to unite nurses in the education and research domains These appointments must evolve to encompass policy-focused activities that will enable nurses to make a significant contribution to the transformation of the health care delivery system     

Building Communities of Practice: The Research Nurse Round Table

This paper shares the experience of establishing a research nurse forum aimed at knowledge sharing, problem solving, and community building from the perspective of a group of clinical research nurses at Massachusetts General Hospital (MGH), a tertiary care center in Boston, ­Massachusetts. We report on a sequence of developmental steps taken to create this forum as an example of best practice for research nurses. Logistical considerations, mission and goals, as well as outcomes and implications for practice are described, with the intent that others interested in building similar forums can replicate aspects of this model within their own practice settings. Clin Trans Sci 2012; Volume 5: 428–431     

Home care nursing in Japan: a challenge for providing good care at home

Home care in Japan has developed over the past 30 years. Nurses have taken leadership in promoting home care and at the same time have expanded their roles. The roles of Japanese nurses in the field of home care are presented in the context of the historical perspective and view for the future. Home care nurses have performed care management for their community as well as for individual older clients living in their community. Currently, nurses work as high-tech and personal care providers and are developing a new role in health care enterprises. The number of nurses working as clinical nurse specialists will increase consistently with the rapid increase of master's programs. In the future, nurses should take a lead in developing health policy. The purpose of the article is to describe the current situation of home care clients and home care nursing in Japan. In addition, four issues of home care in Japan are described related to home care for older persons, high-tech home care, terminal care, and home care for psychiatric patients.     

Strategies to promote and sustain baccalaureate students' interest in pursuing a PhD degree in nursing

PhD-prepared nurses are integral to the delivery of cost-effective, safe, and high-quality care to the increasingly diverse population in the U.S. Nurses with a PhD are needed to develop knowledge that informs and directs nursing care, promote positive health outcomes, and train the next generation of nurses and nurse scientists. Unfortunately, less than 1% of nurses have their PhD in nursing and there is an ongoing shortage of nurses in the U.S. that has not been effectively addressed. The PhD in nursing pipeline needs to be bolstered to address the escalating nursing shortage. This is especially important considering the importance of having an adequate number of well-prepared nurses to address the increasing complexities of health conditions and patient populations in the U.S. This paper presents strategies to promote and sustain interest in PhD in nursing among baccalaureate nursing students and discusses the importance of meaningful engagement in research and engaged faculty mentorship. It is important to incorporate research into undergraduate experiences, promote engaged mentorship during undergraduate level and beyond, and provide a conducive environment for undergraduate students to address their fears, misconceptions, and myths about PhD in nursing.     

Envisioning a National Board of Nursing Specialties: an interview with Jeanette Hartshorn

The Committee for the National Board of Nursing Specialties was recently established to explore ways of enhancing the professionalization of nursing through a unified approach to strengthening the process for certifying specialty nurses. In this interview, Jeanette Hartshorn, PhD, RN, FAAN, project director of the committee, explains the need for the proposed National Board of Nursing Specialties and the effects the board would have on nursing, certifying organizations, health care providers, and consumers.     

Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelines

Nurses work in a constantly challenging and changing environment. Within this context, there is a continuing need for support. Such support will help increase morale, decrease strain and burnout, and encourage self-awareness and self-expression. Clinical supervision address all these issues and enhances the quality of care for patients. While clinical supervision is a policy imperative in Northern Ireland, it was clear that there were problems in its implementation in mental health nursing. The aim of this project was to explore ways to make clinical supervision available to all mental health nurses and to improve and evaluate their contribution to patient care. The research team undertook a comprehensive literature review and a baseline survey of relevant stakeholders. Results represent the outcome of the group work. They will assist healthcare providers to develop local policies and procedures on clinical supervision for practising mental health nurses.     

Outcomes and effectiveness research: capacity building for nurse researchers at the Agency for Healthcare Research and Quality

Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented. AHRQ's mandate is represented by the slogan "quality research for quality health care." Although our understanding has expanded of contributors to and determinants of evidence-based practice and the relationship between clinical care and improved outcomes, we have much to learn. Appreciating how and which components of nursing care influence patient outcomes represents an essential area of research in need of development. While clarifying nursing contributions to improved outcomes is not the sole purview of nurse researchers, it is plausible to assume that a clinical background in nursing combined with strong methodological skills can help policy makers and health system leaders understand how nurses can most effectively contribute to outcomes and quality improvement. AHRQ is clearly interested in capacity building of researchers from all relevant disciplines. Nurses, the largest provider of healthcare, need to build capacity and develop a much stronger presence in the health services research community of scholars.     

Mental health nursing: a global perspective

OGUISSO T. (1995) Journal of Psychiatric and Mental Health Nursing 2 , 41–45: Mental health nursing: a global perspective. : This paper is based on a presentation by Dr Oguisso to the First Hamburg World Forum on Mental Health, 11 June 1994, for the Standing Committee of Presidents of International Non-Governmental Organizations Concerned with Mental Health Issues. Over recent years, the International Council of Nurses (ICN) has been concerned that health providers are sometimes not adequately prepared to give quality care and that resources are often well below those targeted for other sectors of the health care system. In 1991 the ICN chose 'Mental Health … Nurses in Action' as the theme for International Nurses Day on 12 May. With the help of the ICN-provided educational kits, national nurses' associations updated nurses on the problems and informed the public that nurses as a group can provide many of the mental health services to people and answer their families needs.     

Pain management: Ethical issues for the perianesthesia nurse

Ethical aspects of pain management in the peri-anesthesia practice setting revolve around issues of competence. Nurses must have knowledge relevant to the current scope of nursing practice, changing issues and concerns, and ethical concepts and principles. Nurses and other health care providers must engage in ongoing discussion and deliberation about ethics and culturally sensitive care. Additionally, to ensure optimal outcomes, the care provided must address those aspects that are age specific. It is important not only to develop competence as related to tasks and skills, but also to develop critical thinking and decision making. All nurses need to be able to articulate a personal philosophy. They need to understand their own values and be able to anticipate the impact that ethical choice will have on their professional practice.     

Governance education for nurses: Preparing nurses for the future

The complexities of today's health care environment require organizational governing boards to have deeper understanding of health needs, influences, and outcomes with diverse board leadership. Nurses understand the complexities and demands of health care, but few nurses are engaged on boards of directors and many nurses feel unprepared for the governance leadership role. The nurse of the future requires governance knowledge and competencies to influence organizational policies that will improve health care outcomes and advance health promotion. Governance education is a necessary component of preparing the nurse of the future to influence health care transformation. Until nurses can confidently embrace governance leadership as a part of their professional identity, convincing and expecting non-nurse board leaders to appoint nurses to boards will continue to be a challenge. This paper describes a strategy for incorporating governance competencies into nursing curricula across all education levels by leveraging the American Hospital Association Governance Core Competencies (2009) and the Massachusetts Nurse of the Future Core Competencies©-RN (Massachusetts Department of Higher Education Nursing Initiative, 2016).     

Health systems and policy in the USA and in the United Kingdom: an overseas programme

An international programme, especially in a developed country, dramatically increases a student's understanding of health care systems. Students from a university programme in the USA learn about the development and structure of the British National Health Service through lectures and discussion in the US and England, and through 2 weeks of experience in England which include working with community health nurses in a district health authority. Related special experiences are planned which may include interviews with nurses involved in policy development, education, administration and specialty areas. Each student identifies an interest to pursue independently from the perspective of community care. As the student participates in the programme, alternative ways to give familiar care challenge formerly held beliefs. Health care emerges as a dynamic system, one that responds to issues, effects policy, and influences the role of health care providers.     

Advanced nursing training in health policy: designing and implementing a new program

Although the nursing profession has a growing role in the health policy arena, the rapidly changing health care environment means that clinicians need a sophisticated understanding of health policy. Nurses are assuming leadership roles in advocacy, research, analysis, and policy development, implementation, and evaluation, contributing to a growing need to educate nurses to specialize in health policy research and analysis. This article provides an overview of a new master's and doctoral educational program specializing in health policy for advanced practice nurses who are culturally diverse and sensitive to issues of diversity. The program, currently in its third year of operation at the University of California San Francisco, School of Nursing, is addressing the gap in nursing education and practice expertise in health policy. The program is supported through funding by the Department of Health and Human Services Health Resources and Services Administration, Advanced Nurse Training program.     

Mexican Americans' perceptions of culturally competent care

Although the literature abounds with authors' discussions of the need for nurses and other health care providers to deliver safe and optimal care to patients of diverse ethnic groups, little work has focused on defining and measuring the dimensions of culturally competent care. The purpose of this research was to identify culturally competent concepts from the perspective of Mexican Americans. Focus group interviews with Mexican American registered nurses and Mexican American lay recipients of health care were used to explore the participants' subjective perceptions regarding the indicators of culturally competent care. For this group of Mexican American registered nurses, the influence of culture remained strong despite nursing professional experience and knowledge of Western biomedical system. The predominance of themes emphasizing respect, caring, understanding, and patience in health care encounters support the critical importance of personal processes of health care with Hispanics.     

When Shall I Ask for a Second Opinion in Specialized Centers and How Can I Find Them? Do I Need a Medical Therapy in My Disease Course?

BackgroundPenile cancer is an uncommon malignancy in the United States and most developed countries, with higher incidence in the developing nations of Africa, Asia, and South America. Standard treatment involves a urologist, medical oncologist, and radiation oncologist to deliver multimodal treatment in an integrated fashion. This article will discuss the patterns of specialty referral that are important for men affected by penile cancer.Data SourcesAn electronic literature search using PubMed was conducted. Clinical experience also informed the article.ConclusionNurses and other health care providers caring for patients with penile cancer do not always have prior experience with this rare disease. Referral to a high-volume specialty center for multidisciplinary management is often appropriate. Additionally, evidence suggests that men affected by penile cancer experience a range of unmet supportive care needs involving their physical, psychological, and sexual well-being. Timely and appropriate specialty referrals are a means for helping patients maintain an acceptable quality of life.Implications for Nursing PracticeIt is important that oncology nurses understand and anticipate the need for referrals to specialized centers for definitive treatment of locoregional penile cancer. Nurses are also positioned to facilitate specialty referrals and deliver complex supportive care interventions.     

AIDS, nursing, and physician-assisted suicide: Part 1.

Nurses who work in HIV/AIDS care often hold conflicting views about appropriate nursing roles in relation to physician-assisted suicide. Regardless of whether the individual nurse supports or opposes physician-assisted suicide, nurses in HIV/AIDS care need to have a broad knowledge base of the legal and ethical issues related to physician-assisted suicide. This article's main purpose is to provide nurses with the knowledge base they need to assist them in their work in clinical practice, education, policy development, and research.     

An historical perspective on genetic care

The outcomes of genetic research endeavors have the potential to transform health care with significant implications for both providers and consumers of clinical services. Professional and public integration of genetics knowledge is key to successful utilization of genetics information. This article will provide an overview of genetics including a historical perspective, examples of genetic health care, the nursing perspective, and ethical considerations and challenges. New scientific explanations for health, disease, responsiveness to treatment, and design of options for care may create personal and professional dilemmas. Nurses have a responsibility to become active participants in confronting the demands resulting from this new knowledge for education, practice, and policy. The purpose of this article is to provide a foundation from which the profession of nursing can build to enhance current skills and knowledge about genetics to prepare for this transformation in health care.     

What are the sources of health policy that influence nursing practice?

This article seeks to fill a gap in the existing nursing literature by answering the question, "Where does health policy come from?" Nursing leaders agree that nurses should be involved in developing health policy, yet most nurses are not engaged. Many factors contribute to nurses' low rates of involvement, but the primary drivers is that nurses believe they lack the knowledge and skills to influence policy formulation. This article proposes a framework of the sources of health policy. We classify health policy sources as public, organizational, or professional, and provide examples. Nurses with a deeper understanding of the varied sources of health policy can enhance their political competence and more readily act in the policy domain.